The Vestibular, Language, and Literacy Connection
- Kareen Robbins
- May 9
- 5 min read
Updated: May 10
Research confirms that the vestibular system and sensory integration interventions directly impact language and literacy.
Sensory Integration Intervention will facilitate language comprehension and expression. (Ayres & Mailloux, 1981)
There is an increase in spontaneous verbal language after vestibular input. (Magrun, 1981)
Vestibular stimulation activities are effective in improving language among children with ADHD. (Jegadeesan, 2020)
The results of our study allow us to conclude that children with severe language disorders are much more likely to have vestibular dysfunction. (Efimova, 2020)
Vestibular input impacts reading improvement in dyslexic children. (Caldani, 2021)
Neurologically, the evidence of the connection is significant.
The proximity of the vestibular and auditory/hearing apparatus is significant in the vestibular and language connection. (Mansour, et al 2021)
Cochlea- Hearing Apparatus
Semicircular Canals (Lateral, Posterior, and Anterior) – Vestibular receptors that detect rotational head movement.
Otolith Organs
Utricle- Vestibular receptors that detect horizontal linear movement
Saccule- Vestibular receptors that detect vertical linear movement as well as high-intensity sound and vibration.
When we, as occupational therapy providers, implement vestibular interventions, the opportunity to elicit language and reading skills is evident. Whether in the OT room, clinic, classroom, or collaborating with the SLPs on our team or reading specialists and teachers, we can make a lasting impact on a child's ability to communicate. The OT-SLP collaboration through the vestibular system supports facilitation of speech and literacy success in children.
Both vestibular and auditory information are sent to the brain stem nuclei along different branches of the same nerve. The vestibulo-cochlear nerve (Cranial Nerve 8) carries both inputs until they separate AFTER the brain stem.
THIS! The pathways of both auditory and vestibular inputs are so connected!
Auditory and vestibular input travel together to the brain stem and continue in proximity as it travels through the brain.
o Auditory input travels to the cortex
o Vestibular input travels to the 4 brain stem nuclei and then branches to:
Cerebellum, reticular formation, spinal cord, eye muscles, the thalamus and then the cortex.
The vestibular system is the entryway to the brain. It impacts the success of children in so many ways! It will improve postural control, attention and alertness, regulation, smooth, coordinated motor movements, motor planning, proprioception, eye movements, balance, sensory modulation and discrimination, body awareness, and visual skills.
The vestibular pathways also travel to the auditory and language areas of the brain.
4. There is a direct connection with the thalamus and speech areas of the brain.
Cortico-Thalamo-Cortical Loop -Information travels back and forth from the thalamus and Broca's area to allow for the integration of language
Basal Ganglia Connection- Connects with the thalamus and Broca Area to support memory for language
*Broca’s Area is responsible for Speech Sound Production & Expressive Language
Once we have a comprehensive vestibular assessment, interventions may include:
Situational Strategies
Environmental Sensory-Based Strategies
Direct Vestibular Sensory Intervention
Situational Strategies:
o Cotreat with SLPs and/or Reading Specialists
o Schedule Occupational Therapy sessions immediately before speech
and language services (or reading instruction) to provide intense
vestibular stimulation. (Bergo, 1992)
o Complete language and reading activities after recess, gym class, or
playtime.
Environmental Sensory-Based Strategies:
o Provide consultation and guidance with teachers and parents on
sensory-based strategies to facilitate the vestibular system while
learning and reading.
o Lying prone on elbows
o Standing while working and reading
o Rocking in a Rocking chair
o Riding a stationary bike
o Sitting on a therapy ball, wobble seat, inflatable cushion, platform swing,
or cocoon swing.
o Incorporating movement activities into learning and literacy activities.
o Using a Twister mat or rubber discs with letters written on each circle
o Jump in tic-tac-toe squares with words or letters in them
o Use a letter floor puzzle for letter and number identification
o Take a walk while practicing spelling words or conversing
Direct Vestibular Sensory Intervention Considerations
o All body and head positions in all planes of three-dimensional space.
o Speed varies from static (stationary) to fast.
o Movement is linear and rotational.
o Transient (short-term) and sustained (long-term).
o Both the vestibular (saccule) and auditory systems respond to vibration
o Slow, rhymical movement is inhibitory and reduces hyperactivity
o Providing Just Right Challenges (challenging but achievable)
o Vestibular, proprioception, and visual are interconnected. Incorporating
all three areas provides the most intense input. For example, jumping
on a trampoline, reading sight words on flash cards.
o One-point suspended swing provides rapid rotary movements in both
directions
o Prone on scooter board- if head sags and feet drag- underactive
vestibular system, if a child has trouble getting on and off and falls
easily, may be dyspraxic, if afraid to get on, gravitational insecurity.
o Prone extension postures- Stimulates the utricle
o Supine flexion rocking -Stimulates the semicircular canals
o (Ayres, 2005; Bundy,2020)
** An occupational therapy provider trained in sensory integration can implement specialized vestibular sensory interventions following a comprehensive assessment of sensory processing and sensory integration skills.
Provide intensive vestibular input throughout a therapy session with opportunities for vocalization or speech sounds.
o Repetition of words- “Go, go, go, stop” “up, up, up up”, “down, down,
down”, “Jump, jump, jump” while moving.
o Use of rhythmic phrases to the movement: “1,2, 3...”, “a,b,c...” “B says Ba,
Ba, Ba, Ba”,“ M says mmmmmm, mmmmm, mmmmm”, “Lisa, L-I-S-A,
Lisa”.
o Reading sight words, identify letters with sounds, write letters, movement
(spinning on a swing, jumping, moving on a scooter board, prone over a
therapy ball ) read, identify, or write again.
**These recommendations are to be implemented under the guidance of an occupational therapy or other trained professional in the area of sensory integration.
To learn more about the vestibular system and the positive outcomes of language and literacy through effective sensory interventions:
AOTA Approved Course and PDF Informational Sheets: https://www.kareenrobbinsot.com/vestibular-language-literacy-connection-aota-course
References:
Ayres, A.J. (2005). Sensory Integration and the Child, 25th Anniversary edition. Los Angeles, CA: Western Psychological Services.
Ayres, A. J., & Mailloux, Z. (1981). Influence of sensory integration procedures on language development. The American journal of occupational therapy: official publication of the American Occupational Therapy Association, 35(6), 383–390. https://doi.org/10.5014/ajot.35.6.383
Bergo, T. (1992). "The Effect of Vestibular Stimulation on Expressive Language of Pre-Schoolers with Down Syndrome" Master's Theses. 898. https://scholarworks.wmich.edu/masters_theses/898
Bundy, A.C., Lane, S.J., & Murray, E.A. (2020). Sensory Integration: Theory and Practice, 3rd edition. Philadelphia: F.A. Davis.
Caldani, S., Moiroud, L., Miquel, C., Peiffer, V., Florian, A., & Bucci, M. P. (2021). Short Vestibular and Cognitive Training Improves Oral Reading Fluency in Children with Dyslexia. Brain Sciences, 11(11), 1440. https://doi.org/10.3390/brainsci11111440
Efimova, V.L., Nikolaeva, E.I. (2020). The Role of the Vestibular System in the Development of Specific Language Disorders in Children. Human Philosophy 46, 306–311. https://doi.org/10.1134/S0362119720030032
Jegadeesan, T., & Nagalakshmi, P. (2020). Effect of Vestibular Stimulation on Language Skills of Children with Attention Deficit and Hyperactivity Disorder. Indian Journal of Public Health Research & Development, 11(12), 83-87. https://doi.org/10.37506/ijphrd.v11i1.13220
Magrun, W. M., Ottenbacher, K., McCue, S., & Keefe, R. (1981). Effects of vestibular stimulation on spontaneous use of verbal language in developmentally delayed children. The American journal of occupational therapy, 35(2), 101- 104. https://doi.org/10.5014/ajot.35.2.101
Mansour Y, Burchell A and Kulesza RJ (2021). Central Auditory and Vestibular Dysfunction Are Key Features of Autism Spectrum Disorder. Frontiers in Integrative Neuroscience. 15:743561. https://doi.org/10.3389/fnint.2021.743561
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